Provider Demographics
NPI:1306325428
Name:LOPER, CARRIE A (PA)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:A
Last Name:LOPER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:684 SIXES RD STE 235
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8722
Mailing Address - Country:US
Mailing Address - Phone:678-388-6500
Mailing Address - Fax:678-388-6501
Practice Address - Street 1:684 SIXES RD STE 235
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30115-8722
Practice Address - Country:US
Practice Address - Phone:678-388-6500
Practice Address - Fax:678-388-6501
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA008928363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical